Radiation Oncology Residency: Education

Pictured: Michael Zelefsky Radiation oncologist Michael Zelefsky (right) performs a brachytherapy procedure. Residents are given the opportunity to directly participate in all aspects of these procedures.

Memorial Sloan Kettering’s radiation oncology residency program is a comprehensive training experience that covers all aspects of clinical radiation oncology, radiobiology, and radiation physics, as required by the Accreditation Council for Graduate Medical Education (ACGME).

Training emphasizes a multidisciplinary approach to the management of cancer, with opportunities to gain exposure to medical and surgical oncology, in addition to the full range of radiation oncology ACGME subsites. Our residents are encouraged to attend the multiple interdepartmental tumor boards and conferences, which take place daily.

Learn more about aspects of our residency.

Orientation

The program begins the first week in July, with an orientation and introduction to the daily routines of the department. Following the completion of orientation, incoming residents are closely assisted by the chief residents and assigned experienced senior residents specific to their starting clinical rotations.

Introductory lectures are held to discuss fundamentals of clinical radiation oncology, radiation physics, and patient management.

Clinical Curriculum

During the first, second, and fourth clinical years, residents are assigned to a series of approximately ten- to 11-week rotations during which they work one-on-one with an attending physician. The rotation schedule is planned by the residency program director and chief residents.

The department is organized based on organ site, and each rotation will concentrate on either an organ/disease site or a specific attending’s clinical area of interest. Although the majority of patients seen will be in the area of clinical interest, all attendings see general consultations for inpatients and palliative treatment. Accordingly, residents will also be trained to manage inpatient and radiation oncology emergencies, as well as principles of palliative care.

Residents routinely see patients in the outpatient clinic where patients come for initial consultation and return for follow-up care. Under the attending physician's supervision, residents perform simulations of new treatments and assist with treatment planning and status checks for the patients assigned to them. Residents regularly participate in reviewing treatment plans and may participate in weekly chart rounds as well.

ACGME Subsites

Conferences

During each rotation, our residents participate in specialty tumor boards and conferences with the faculty. ACGME medical oncology, pathology, and diagnostic imaging requirements are satisfied by the multidisciplinary disease management team (DMT) conferences in central nervous system/spine, head and neck, thoracic, gastrointestinal, genitourinary, gynecologic, lymphoma, and pediatric malignancies.

These conferences are attended by representatives from medicine, surgery, and radiation oncology, as well as site experts in pathology and radiology. In some cases, residents will be given the opportunity to present and discuss patient management issues at these conferences.

Physics and Radiation Biology

During the first three years of the training program, residents participate in an in-house weekly physics curriculum designed to provide a framework for understanding external-beam radiation therapy treatment planning and delivery, brachytherapy physics, radiation safety, and diagnostic imaging physics.

In addition to didactic lectures, hands-on sessions are regularly conducted to illustrate techniques in simulation, planning, and brachytherapy procedures. Course content is reviewed and updated yearly with direct input from the residents.

During the first three years, residents also participate in a weekly joint radiobiology course offered to a group of participating New York City radiation oncology programs. This course is designed to provide an understanding of the classical and molecular effects of radiation, radiation and cancer biology, and laboratory techniques used in radiobiological research. The collaborative inter-institutional nature of the course allows residents to network with trainees from other programs in New York City.

Procedural Training

Memorial Sloan Kettering has one of the strongest brachytherapy programs in the country, with world experts in prostate and gynecological brachytherapy, intraoperative radiation therapy, and special procedures in brain, spine, and other subsites. The Brachytherapy Service is supported by a dedicated fellow and nurse practitioner.

Background is provided in didactic lectures and hands-on demonstrations, and residents are given the opportunity to directly participate in all aspects of brachytherapy procedures.

Grand Rounds

In our weekly Grand Rounds presentations, local experts and visiting professors present on contemporary topics. Residents also have opportunities to present their own research at Grand Rounds.

Prior to presenting at the American Society for Radiation Oncology conference, residents are given an opportunity to share their work before our faculty and the Memorial Sloan Kettering community. Residents also take the lead in making case presentations at our morbidity and mortality rounds.

Electives

Memorial Sloan Kettering is a comprehensive cancer center, and no away rotations are required to satisfy any ACGME requirements. However, residents may wish to pursue focused educational enrichment activities within a research area or clinical subsite.

Elective rotations may be individually designed according to our residents’ interests in specialized aspects of radiation oncology or in other oncology fields, such as medical and pediatric oncology, cancer pathology, and biostatistics. Electives may be performed in other ACGME accredited training programs with the permission of the training program directors.